How Digital Technology Applications and Integration helps in increasing MACRA Reimbursements

For those who view the Medicare Access and CHIP Reauthorization Act (MACRA) as an administrative and reporting distraction, it’s time to take a second look. MACRA referred to as the “Permanent Doc Fix”, is the largest healthcare reform in the United States since the Affordable Care Act. MACRA, signed into law on April 16th, 2015, makes significant changes to the way Medicare doctors are reimbursed by rewarding quality care over volume. MACRA is intended to use the payment system to fundamentally change the way care is delivered, especially for patients with chronic diseases or who need complex medical management. The new reimbursement system is called the Quality Payment Program (QPP) and it consists of two tracks: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.

MACRA is also rewarding clinicians and groups for using information technology and data in this reimbursement approach. New rules under MIPS depend on patients being more engaged in their treatment and more informed about the decisions they are making. It is to accomplish with interactive technology that allows providers to customize patient education and provide timely, personalized reminders and care instructions that engage patients over time. Hence it can be said that improved patient outcomes and accurate reporting are a key part of meeting MACRA requirements and taking advantage of incentive payment programs.

Digital technology applications and integrations will have a major impact on value-based care with the new reimbursement program. CMS predicts organizations that do it right may be eligible to receive up to a 3.58 percent exceptional performance bonus for the 2019 performance year paid in 2021. With an estimated total of 11 percent in reimbursement influx, integrating digital technologies and applications will play a major role in helping organizations increase their return on investment, and more importantly, increase the quality of care for patients.

MACRA and technology: Using advanced tools for insights, engagement and better outcomes

One area that is often overlooked is using technology to improve patient satisfaction, speed of treatment, and accuracy, which can positively impact patient outcomes. Technology can enable you to extend your resources, and connect with others who can help improve outcomes and increase patient connection and engagement. From technologies that allow people to manage their health more effectively, to better ways of diagnosing disease, to monitoring the impact of policies on population health, here’s how digital technologies for health are having a profound effect on how health services are delivered and reimbursed.

One area that is often overlooked is using technology to improve patient satisfaction, speed of treatment, and accuracy, which can positively impact patient outcomes. Technology can enable you to extend your resources, and connect with others who can help improve outcomes and increase patient connection and engagement. From technologies that allow people to manage their health more effectively, to better ways of diagnosing disease, to monitoring the impact of policies on population health, here’s how digital technologies for health are having a profound effect on how health services are delivered and reimbursed.

1. An effective EHR improves data storage and handling, and offer insight into patient utilization patterns. Thus, fully optimizing your EHR can help with MACRA compliance.
2. Technologies integrated with the EHR helps physicians make better and faster patient diagnoses while also connecting other physician networks in order to process referrals and sending prescriptions to pharmacies.
3. Patient engagement technology can play a key role in helping to reduce preventable healthcare costs.
4. There are many patient engagement tools that can be leveraged to enhance Improvement Activity measures. Examples include automated reminders, which can be leveraged for measures such as “Improved Practices that Engage Patients Pre-Visit” and “Chronic Care and Preventative Care Management for Empaneled Patients;” or post-visit text messages that provide patients access to satisfaction surveys for the “Collection and Follow-Up On Patient Experience and Satisfaction Data On Beneficiary Engagement” measure.
5. Properly used data analytics can help identify costs and quality performance opportunities that may lead to improved patient care and market share.
6. Beyond extracting the data, sophisticated analytic tools ensures reporting choices to enable the best scores.
7. Population health analytics plays an important role in identifying patients with rising risk who are not obvious in the day-to-day flow of patient care.
8. An integration engine that is flexible enough to connect to any HIE can greatly assist clinicians in scoring better in the HIE objective.

However, there are a number of requirements that healthcare professionals must follow in order to receive reimbursements and avoid penalties

For healthcare organizations, there’s a lot on the line. If healthcare professionals do not meet MACRA’s requirements, organizations run the risk of losing up to 7 percent of Medicare reimbursements. To satisfy the requirements of the Quality Payment Program under MACRA and receive the reimbursements, providers are required to have:

1. EHR use at the core of the Quality Payment Program with both MIPS and APMs, requiring the use of certified EHR technology to qualify for positive Medicare payment adjustments.
2. Patient access and exchange of health data through health technologies, which in turn require interoperability to be achieved fully.
3. Integrate and streamline the data – ensuring it is easy to receive from various data points, and share with outsiders.

Get Help

It is in the best interest of clinicians and groups to incorporate digital technologies that engage patients once they leave a facility, enhance care coordination efforts, and improve patient outcomes. Physicians must start thinking about how technology can help them improve the care they provide. If you need guidance, get help. Engage an expert to help you navigate the first stages of MACRA. More help at the right time and place can make a big difference.

For 2019, Improvement Activities Performance Category accounts for 15% and Promoting Interoperability Performance Category accounts for 25% of your Composite Performance Score. Register for our webinar where our experts will give you an in-depth analysis of MIPS/ MACRA, provide a MIPS/ MACRA reporting strategy for 2019. iPatientCare will walk you through the Key changes in how you will be scored on Improvement Activities and Promoting Interoperability and how to improve your score in these categories.